Ear Problems-Maybe reverse squeeze?

[sytech]

When I came home from Bonaire last year I had some middle ear problems. When the plane left Bonaire I experienced pain in both ears.

I saw my ENT who put me on Cortisone tabs (to dry the water in my middle ear) as well as an antibiotic. The MD told me to irrigate my ears with Domeboro solution after diving to dry up any water in my ears.
This problem resolved after a few months and have taken 3 dive trips since then with no problems.

I just came back from Bonaire and had no problem equalizing on descent but was aware of air expansion in my ears upon ascending. What I have always done is to stop my ascent, hold my breath and gulp and this seems to help somewhat. I had gotten this advice from scuba books as well as from this forum regarding holding my breath for a second or two which is ok as long as you have stopped your ascent.

Anyway, after every dive day in Bonaire my ears were clogged with water and this was very annoying. I used the Domeboro and the problem resolved after several hours. Upon leaving Bonaire I had no pain in my ears as I had last year.

I would like to prevent this in the future as it prevented me from doing as many dives as I would have liked. I will be seeing my ENT just to get it checked and to see if I have any wax build-up which may have contributed to the problem.

Any advice will be appreciated.

Thanks,


Sy

 

[headsqueeze]

Probably the best preventive measure for your symptoms is becoming really good at equalizing the middle ear. Even so, it's probable that you are developing some minor barotrauma and with improved technique, the barotrauma will diminish too. It just takes time, but you can practice out of water. Forceful equalization does not mean efficient. While helping 3 other divers learn to equalize, I learned that minor barotrauma can develop with too much force. Also, air travel alone may cause barotrauma: Otic barotrauma from air travel.

Jala Neti, or nasal lavage will help too.

A GENTLE Frenzel Manever works best for me. I like it because it can be used on descent or ascent.

 

[doctormike]

When I came home from Bonaire last year I had some middle ear problems. When the plane left Bonaire I experienced pain in both ears.

I saw my ENT who put me on Cortisone tabs (to dry the water in my middle ear) as well as an antibiotic. The MD told me to irrigate my ears with Domeboro solution after diving to dry up any water in my ears.
This problem resolved after a few months and have taken 3 dive trips since then with no problems.

I just came back from Bonaire and had no problem equalizing on descent but was aware of air expansion in my ears upon ascending. What I have always done is to stop my ascent, hold my breath and gulp and this seems to help somewhat. I had gotten this advice from scuba books as well as from this forum regarding holding my breath for a second or two which is ok as long as you have stopped your ascent.

Anyway, after every dive day in Bonaire my ears were clogged with water and this was very annoying. I used the Domeboro and the problem resolved after several hours. Upon leaving Bonaire I had no pain in my ears as I had last year.

I would like to prevent this in the future as it prevented me from doing as many dives as I would have liked. I will be seeing my ENT just to get it checked and to see if I have any wax build-up which may have contributed to the problem.

Any advice will be appreciated.

Thanks,


Sy

Hi, Sy... thanks for posting!

Here are a few thoughts (I'm plagiarizing a bit from one of my previous posts...)

1) Outer ear problems and middle ear problems are very different in terms of causes, treatments and physiology. However, they can both give a "clogged" sensation, and may occasionally occur in the same patient, making it common to blur the lines between these two conditions on these discussions.

People often are inexact when they use the term "equalization". To a non-medical diving audience, this may refer to anything they do to relieve a feeling of fullness in the ear. They may be re-ventilating the middle ear (the space behind the eardrum), or they may be draining the outer ear (the space outside the eardrum), and having similar subjective sensations.


2) Outer ear problems are primarily related to irritation and infection of the skin of the ear canal, and are treated by cleaning out any impacted wax or other debris, drying the ear, and using topical medications (Domeboro solution, antibiotics, steroids, alcohol, vinegar, etc...). Here is one of my posts on that topic: http://www.scubaboard.com/forums/3792526-post16.html.

A good way to prevent these problems is to see an ENT doc and make sure that your ear canal is clean, and then to use the ear dryer mentioned in the abovementioned post. Many people swear by eardrops as a preventative measure, but I still think that careful cleaning and drying is better, and less likely to cause problems related to the drops themselves.


3) Obstruction in the outer ear - from earwax, osteomas ("surfer's ear"), foreign bodies (e.g. earplugs) - can to some small degree impact on the ability of a diver to clear the middle ear space. True equalization generally relies on the eardrum moving outwards, since the other walls of the middle ear are unyielding bone. This is usually associated with the opening of the Eustachian tube (the natural drainage pathway of the ear). SO, if there is something that is blocking the eardrum from moving, theoretically this could make equalization more difficult. One could imagine a situation where a partially blocked outer ear combines with water to cause this problem - to be relieved when the water drains out (maybe with eardrops). However, this is not a very common scenario, and while removing impacted earwax helps a lot in preventing an OUTER ear infection, it really doesn't have much to do with equalizing.

4) Nasal steroids (e.g. Flonase) are good for for nasal obstruction due to allergies or other types of congestion, but have not been shown to affect the function of the Eustachian tube. In fact, in children, even decongestants like Afrin and Sudafed have not been shown to be helpful for middle ear fluid:(OME): Practice Guidelines - June 15, 2004 - American Family Physician

5) Since there isn't a lot of literature on this in adults, and since I don't get to dive very often, if my ear locks up on a dive trip, I take decongestants and steroids (no WAY I'm missing a precious dive unless it's absolutely necessary!). Steroids are controversial and have side effects, so I'm reluctant to prescribe them for others.

6) Equalizing correctly, early and often is probably the best way to prevent middle ear problems. If you haven't seen it, this video goes over techniques: Doc's Diving Medicine Home Page


Happy diving!

Mike


PS Bonaire is fantastic, isn't it?